Strokophobia in the stroke care continuum: An under-recognized global phenomenon with profound implications

As health systems globally grapple with increasing stroke burden, physician shortage and fragile healthcare infrastructure, an understudied and yet underrecognized phenomenon is gaining attention. Just as the more widely described neurophobia, gaps within the stroke educational and training ecosystem lead to strokophobia - a phenomenon that describes fear or hesitation among health care providers and trainees with diagnosing and managing patients with stroke. It often stems from lack of interest, perceived difficulty/complexity, low confidence and inadequate knowledge of stroke neurology or unfamiliarity with stroke care protocols. This fuels prognostic pessimism which may lead to poor outcome. Gaps in stroke neurology education and ensuing strokophobia have implications across all strata of the stroke care continuum, from early-career practitioners (medical students/residents and other health-care trainees) to advanced-career practitioners (clinicians and stroke-support staff) and the community (caregivers, policy makers and payers). This review explores strokophobia, highlights the burden and implications for stroke care globally, while proposing a three-tier strategy to addressing the problem with the aim of improving confidence and clinical outcomes. Specifically, we describe targeted educational strategies that should be implemented across the stroke care continuum from the student/trainee level to clinicians as well as care givers and policy makers, with the aim of building a robust stroke care ecosystem. Tailored stroke education should be designed to the specific context and target population to improve usable knowledge, boost bedside clinical confidence and competence, increase interest and ultimately improve clinical outcomes.